Fat Acceptance: McDonalds, Advocacy, Fat Pride, and Swear Words

Ana's Note: This is a Fat Acceptance 202 post, not a 101 post. If you need a 101 course on Fat Acceptance, please refer to Kate Harding's excellent archive; there are about 10 linked posts in that archive and they are all awesome and admirably cover most FA 101.

On May 29th, the day immediately following this year's U.S. Memorial Day holiday, I will be hospitalized. At 7:30 a.m. in Central Standard Time, I will be wheeled on a stretcher into an operating room. I will probably be naked except for a thin hospital gown tied at the neck. I will at that point also most likely have a sedative, most likely Valium, in my system. I will be given a deeper sedative to force my body into unconsciousness, at which point a surgeon will cut open my back and operate directly on my spine.
Because I am fortunate enough to have health care that covers this surgery and my extended hospital stay, I will be staying at least five nights in a hospital room. I will be sleeping alone, for the first time since I moved in with my Husband, not counting his occasional trips for work or to visit his children. During visiting hours, my Husband will be in my room, by my side, reading books, watching movies, and trying to help me remember that everything will be normal again, eventually.

He will also, sometimes, eat food during his visits.

We're not yet sure how he's going to do this, but we're fairly confident that he will in fact have to. He has, after all, been eating three square meals a day for many years now, and we don't think his body or mind or attitude would adjust well to an extended 5-day fast. Nor do we think that an early-morning + late-night eating regimen will be good for him -- he tends to need food around the midday, you see.

We're hopeful that the hospital will have food for him to order and eat. He doesn't know his way around the town where my hospital in located -- it's over an hour's drive from our house and it will be a struggle for him to find both food and parking. And every hour that he spends searching for food is an hour that I'm left alone, and frankly "alone and in pain" isn't something I personally enjoy. If I must be in pain, I'm selfish enough to need him at hand.

The hospital website tells us that there is a "cafe" with "light snacks" that visitors can buy and consume. But there is no menu included to tell us what kinds of "light snacks" are available or whether or not the ingredients are things he can even safely consume, let alone will enjoy. In fact, the most specific detail about the cafe contents is that it "proudly brews Starbucks coffee", which sounds very nice to some, I'm sure, but less so to Husband. There are also, apparently, vending machines scattered throughout the hospital, which is again very convenient, but I don't think Husband can live for 5 days straight on vending machine food.

So when I saw this tweet this week, my first thought was "fuck, yeah, that sounds awesome". And that's a pretty direct quote from my brain.

But to my utter disappointment, the included link was not a poll about food accessibility to hospital visitors. It was not a post about the comfort of having a food "baseline" in unfamiliar areas and how familiar things like fast food grilled chicken sandwiches or parfaits or those little pre-packaged cereal bowls can be a boon to people seeking food in unfamiliar surroundings and in emotionally vulnerable circumstances where they just want to satisfy their hunger quickly, easily, safely, and familiarly before returning to care for their loved ones. And it was not a post about the healing power of scent and food memory when a patient needs a small reminder of their "normal" life and what they may again soon return to.

No, this was a post about an "advocacy" group who is spending time "advocating" that 27 hospitals out of 5,754 hospitals in the U.S. should drop whatever they're doing and remodel the McDonald's kiosk out of their cafeterias. Why? I'm so glad you asked!

Because Fat People are stupid! The group claims that "featuring McDonald's in hospitals "unintentionally [boosts]" the perception that the food is healthy". Which is totally what I think when I hear there might be a McDonald's for my Husband to eat in! I think, "Oh, good! Healthy food endorsed by the hospital!"

Because Fat People are expensive! Some "government studies have found that health care spending is dramatically higher for obese adults than normal-weight adults"! Which is totally not because Fat People are regularly denied valuable preventative treatment by fat-phobic doctors who blame warning signs on Teh Fats!

Because Fat People are outnumbering Thin People! "A report released earlier this year predicted that 75 percent of Americans would be overweight by 2020"! And this is Obviously A Very Bad Thing! Because having more people who dare to be Fat In Public is Obviously Bad! Haven't they gotten the memo that they are ugly and disgusting and horrible?!

Well, I don't know about you folks, but I am convinced! Clearly, the 0.4% of hospitals in the U.S. that have a McDonald's kiosk for the comfort and convenience of their patients' guests should make this a Very High Priority! And now I am going to say something that is probably going to sound a little harsh, but I'm not feeling so fluffy-bunny today so them's the breaks, and that something is:

If you are a so-called "advocacy" group who deliberately blows out of proportion a non-story factoid about 0.4% of hospitals in the U.S. having McDonald's kiosks in their cafeterias in order to spread propaganda about fat people being stupid, ugly, expensive, disgusting drains on society, then you are a goddamn hate group. You are a goddamn hate group because oh my god could you be any more obvious in your hatred of fat people but you are also a goddamn hate group because your "primary purpose is to promote animosity, hostility, and malice" against me, people who look like me, and people who have a genetic predisposition to look like me.

I say that is your primary purpose because I do not believe you care about education, because if you cared about education you would spend less time claiming that people think that consumption of anything on hospital grounds, including used coffee grounds and wallpaper paste is endorsed by the Surgeon General, and would instead spend more time on advocacy for meaningful food content labeling in restaurants which would not only educate The Fat People but would also be a boon for people who believe that food allergies, food intolerances, and hell food preferences, matter.

I say that is your primary purpose because I do not believe you care about health, because if you cared about health you would spend less time complaining about how The Fat People are a drain on the health care system (while conveniently ignoring many, many other high-risk and high-cost health behaviors which are in most cases arguably more of a 'choice' than one's weight and body type), and would instead spend more time on advocacy for a non-fat-phobic medical system in our country that provided comprehensive health care for all people regardless of body type and which embraced the understanding that health and body size are not closely correlated and that fat people can be healthy and thin people can be unhealthy and vice versa.

I say that is your primary purpose because I do believe anyone who says they fear the day when the Thin People are outnumbered by the Fat People. I believe you when you say that, because I'm exceedingly familiar with that same argument being used about the Dark People outnumbering the White People. But you know what? The people who worry about that are also goddamn hate groups. So well done, you, if you are a member of a group who says that sort of thing: You're not just a hate group, you're a plagiarizing, uncreative hate group. Way to set the standard!

I say to any such group here and now as a fat woman with a thin husband, a proudly fat woman who is about to be hospitalized as a result of a disability that is tied as deeply into my genes as my fatness is, a fat woman who was dismissed and misdiagnosed by dozens of medical doctors for years because obviously the only problem that a fat woman can have is that she's FAT NO DOY, as a fat woman whose thin husband will be forced to choose between leaving my side in the hospital and living on vending machine chips and soda because there's not a self-subsidized fast food restaurant downstairs selling grilled chicken sandwiches to the general public, I say to you this:

Quit draping your fat hatred in bullshit advocacy terms. You are not my advocate. Fuck you very much.

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comments:

I didn't even get as far as considering the visitors. My thought process went "You want to deprive sick and injured people of comfort food, and you think this is a good deed? Fuck that." *deletes email*

It seems to me the note about this being a 202 post would be better placed at the beginning. That way people can follow the link, read the 101 posts, then return to read this.

My hospital, which is teh awesome, has a great cafeteria. Not just great for a hospital, but great. They have a grill, Chinese food, Midwest-Mex (with some of the best tomatillo salsa in town), a sandwich bar with fresh-baked breads and an awesome salad bar. They make omelettes to order, consistently have delicious melon, and a wide selection of baked goods, snacks, desserts, and beverages of all kinds.

If you're a patient, you can order from the kitchens at any time of day, whatever you want off the menu unless the doc has put you on special diets. You can order for visitors, too. There is a limit somewhere, but it's not caloric or three meals a day - I can't remember what.

There's a mini-cafe in the lobby with coffee, pastries, and delicious delicious sandwiches from a local Italian deli, and a convenience-store-type thing that sells snacks, and often there are groups that come in to sell sweet or savory treats for a good cause.

The food is relatively cheap. (With the exception of the triple-tier chocolate cake that is worth every single penny of the $4 I pay for it.)

I do actually think this is better than a McDonald's, and I would advocate against one - for us. We have the comfort food angle down. The burgers are better quality and come with more options, and they're in a context of plenty: it is easy to assemble your own lunch from the smorgasbord of possibilities. Because of the layout, there's no real need to *just* eat from the grill, which is really freeing from a free-eating standpoint: you have free choice. I think if we had a McDonald's, I'd feel like it was a choice between two places, rather than an addition to the bounty. And, in general, I think McDonald's comes with a lot of stigma that hospital patients and visitors don't necessarily need - as long as the need for cheap, comforting, familiar, fast, pleasurable food can be settled in other ways. I wouldn't want a mall-type food court in my hospital. I would hold up my hospital as pretty much the ideal. (It would be nice if they'd deliver to waiting rooms, or maybe have a little dim sum cart, but maybe that's in the works.)

Their food selection recognizes and validates a huge range of needs for eating, and accommodates ways that people eat, and I think that should be the model. I *am* uncomfortable with bringing corporations into hospitals, and privatizing aspects of care that are integral. (And eating is integral to healing and care.)

But.

I am given to understand that my hospital is a remarkable institution, though. Visiting another local hospital, which had basically convenience store food and the saddest salad bar on the face of the planet, I would have been grateful for a McDonald's. It's all about context and circumstance.

I would like to find ways that hospitals can support the needs identified, and I do think that having a cafeteria of one's own is the best way to offer that. In cases when that's not possible, access to quick, comforting, familiar, cheap foods through McDonald's is better than, you know, not eating. But I would be concerned that including McDonald's does send bad messages: either that kind of food is being *separated* from other options, marked as different (and thus possibly shaming people for eating from McDonald's rather than the "healthy" cafeteria), or it (possibly with other chains) replaces a cafeteria that is best able to provide a range of flexible options tailored for its population.

I feel I have to respectfully disagree (of course, I can't shine a light into the group's mind, but what they claim doesn't strike me as anything like a hate group).

>Because Fat People are stupid! The group claims that "featuring McDonald's in hospitals "unintentionally [boosts]" the perception that the food is healthy".

But everyone is 'stupid' most of the time, except when we make a special effort (cue to one of the skillions of studies along the lines of "these students all agreed that smoking was bad for them, and wanted to quit, but it turned out the most effective way was to put the cigarette packets in plain boxes" or something like that). We're full of biases, and our minds always try to do the least effort. The best way to cut down on cookies is to move the packet to a slightly inconvenient location, and so on. Pictures of skinny models make teenagers feel bad about their bodies. Pictures of cowboys make cigarettes more virile. None of these make rational sense, but they still affect us.

Since people in hospital will still want to eat, banning Mcdonalds-ish places will simply put a more healthy option instead.

>Because Fat People are expensive! Some "government studies have found that health care spending is dramatically higher for obese adults than normal-weight adults"! Which is totally not because Fat People are regularly denied valuable preventative treatment by fat-phobic doctors who blame warning signs on Teh Fats!

As far as I can tell, no, this is not the main reason. I'm sure it contributes, but things like type 2 diabetes are unpleasant, expensive, and fat (+genes) induced. Just because there are a whole load of intolerant, prejudiced anti-fat people out there, doesn't mean that the country as a whole wouldn't be better if more people lost weight.

Now, I know from experience how extra-ordinarily hard it can be to lost weight, and I know that fat-shaming is singularly unhelpful, and I wouldn't want to force anyone to diet or whatever. But if there were background interventions like this that would result with (on average) less obesity, I'd say they were all to the good.

This is a Fat Acceptance 202 post, not a 101 post. 101 subjects include "Why People Aren't Stupid And Can And Do Make Good Decisions For Themselves" and "Why A Great Many 'Fat Diseases' Are Correlated With Fat Rather Than Caused By Fat And Ultimately Share Underlying Causes" and "Why A Good Many People Cannot Lose Weight, And Words Like 'Hard' And 'Easy' Simply Do Not Apply To Their Situation".

People who are not familiar with these 101 concepts are please asked to educate themselves elsewhere as 101 topics are not the point of this post and the underprivileged fat commenters here have only so many spoons between them to educate (again, and again, and again) these 101 concepts.

I don't like McDonald's. But it is comforting to have something familiar, especially when you're scared or in pain or lonely or homesick or grieving. Familiar can mean lots of different things, including foods that normally disgust you. Stress can radically change appetite and preferences.

TW: disordered eating, serious pain/injuryI badly injured my arm a couple years ago - dislocation + multiple breaks. It required a lot of time to heal, and was I was a wreck. I simply had no appetite for anything for weeks. Even when I got hungry, I had no desire to eat. This is very rare for me, and had never gone on so long.

The things I found myself willing to eat were different than what I usually wanted. Gingerbread. Hash browns. McDonald's fries. Those cinnamon twist things from Taco Bell. Foods that I hadn't even though about in years, basically, and not stuff I normally go to as comfort food when I'm well. The hospital cafeteria let me eat hash browns and pecan pie (and no one looked at me funny for buying just that, thank God). Or milk and peanut butter toast. Or, one day, just a giant plate of grilled chicken strips from the salad bar. I never had any hunger for McDonald's hamburgers, but one day someone gave me a ride home, and we stopped there and I bought several of those fish filet sandwiches, purely for the taste of the tartar sauce, because it reminded me of eating them with my grandparents as a kid.

Suart Armstrong: You are missing the point and your science is weak. The links that Ana has moved to the top of this post can readily be explored to find rather a lot of scientific evidence that, no, weight is not nearly as big a deal as people say it is, desperate attempts at weight loss are associated with much more harm than good, and the Surging Tide Of Faaaaaaat is not giving everyone diabetes. I get that you're trying to help, but you're helping the wrong side of the issue.

Example: there's a claim I've heard quoted a lot recently (more than once from a young guy in our office who's a competitive runner) that the current younger generation will be the first to have a shorter lifespan than its predecessors. It turns out that if you trace this oft-quoted claim back far enough, it is based on almost no evidence, and the evidence that it is based on was the result of a badly-constructed study that was completely debunked by the CDC (the C-D-freaking-C) one month after its publication.

Since people in hospital will still want to eat, banning Mcdonalds-ish places will simply put a more healthy option instead.

I just want to address this real quick.

TW: Disordered eatingNo. When I didn't have access to food that tempted my appetite, I didn't eat. And when you don't eat, you can't really do well on opiates, which leads to more nausea/pain, which is an endless spiral of suck. (Luckily, it was *just* suck for me, and I could overcome it and got better. It can be worse than suck if you can't kick it.)

This is bad enough when you're "just" injured, and it's temporary, but it can negatively affect outcomes in, say, cancer patients, who *need* to be eating.

Incidentally, I wrote this post BEFORE a day visit to said hospital for a CT myeliogram this last weekend. So I can update with relevant information!

The hospital is extremely pretty and clean and nice, and there was a whole menu that I had available to order from since they held me for observation and wanted me to eat. The lunch menu had some dubious-to-me-because-of-various-food-intolerance-issues sandwiches, so I ordered the one thing left: a plain burger.

The meat was overcooked into leather, but the bun was soft so I ate that. I wasn't really hungry anyway, and was feeling pretty weak so that worked out. But I mention that to mention this, which is that the cafeteria would have also cooked up the same for Husband had he been hungry. But it would have cost $10 for his plate.

I don't begrudge the hospital that $10. I imagine they're probably already running that cafeteria at a loss in order to serve the patients. But let's not pretend that a $10 lunch of a leathery-burger with zero sides and a 6 oz mini-soda is an affordable meal for patients' guests who don't make what Husband and I make for our living.

But, eh, poor people. They probably don't have healthcare anyway, so they wouldn't be in hospital to begin with, amiright? Gods, my country.

I'm going to pull just this one quote: "Since people in hospital will still want to eat, banning Mcdonalds-ish places will simply put a more healthy option instead."

Not necessarily. In fact, probably not likely. It's a food service cafeteria run by a contractor.

The hospital to which I've taken my husband to the ER of twice in the past year and thus had to feed three children several meals at does not have a McDonald's. But the food in the cafeteria was not (on the whole) any healthier than you'd find at a McD's--and sometimes a lot more expensive. There was a very sad salad bar. There was greasy pizza by the (plate-sized) slice. And, fortunately, there was a very overpriced fried chicken platter with two sides (green beans with ham and mac and cheese) that I spent my last $8 on and was able to feed all 4 of us with for dinner one evening--despite the fact that it was intended as a meal for one person.

Not necessarily. In fact, probably not likely. It's a food service cafeteria run by a contractor.

Interesting. So in the case of your hospital, the fact that it DOESN'T come in a McDonald's wrapper actually creates the impression (in the minds of people not aware of the contractor-nature of the food) that the food is healthy and endorsed by the hospital?

Sounds like a good case for food-label advocacy. But that's not a sexy cause likely to be taken up by the fat-phobic groups despite the fact that it would be demonstrably more helpful across the board.

Assuming that things work there the same way things work at my mother's hospital, anyone below the level of doctor (or administrator) probably either eats at the cafeteria, brings in their own food from home (in which case they heat it up and eat it in the staff lounge), or doesn't eat during their shift.

Have you considered talking to the hospital staff about what your husband's options might be? Most nurses and aids consider it part of their job (and actually, it is) to be as reasonably helpful to the family and friends of patients as possible during their visit.

I often eat McDs while traveling because I know exactly, down to the number of pickle slices, what I'm going to get. I don't exactly like their food, but I don't dislike it, either, making it something I can stomach even when under a whole lot of stress. Which is practically the definition of comfort food, right there.

You know who else finds McDonald's comforting?

Most kids.

You know who REALLY needs comfort food?

Kids who have a parent in the hospital. Or who are themselves patients.

Naomi just said what I was coming back to say about kids and comfort food. Even the (at the time almost) three year old was picking up on "Mom is really, really scared", despite the fact that I was going out of my way to remain as calm as possible and not project emotions/fears. Having a Happy meal, while not the best choice nutritionally, would have gone a long way...

The other thing that often goes unmentioned by people like that is that a lot of McDonalds do have non-sandwhich food nowadays. I can't stand McDonalds burgers, but they do have salads and milkshakes and yogurt cups and so on.

I don't think that it is particularly relevant to why those people are wrong... but my stomach gets kind of sad at the thought of McDonalds burgers. I'd hate to be trapped in the hospital with no other options. But even if all the hospital has is McDonalds (which seems unlikely?), I wouldn't be.

If you are in the hospital or hanging out at a hospital long enough to need to eat there, you're probably running short of spoons already. Getting a known quantity, even if it is neither the most tasty nor the most 'healthy' (what, yogurt loses its magic powers if it comes in a McD cup? All the nutrients are sucked out of lettuce and sad, sad cherry tomatoes within a thousand feet of the golden arches? Beef patties lose their protein?), that is easy and quick to eat is more important than the 'appearance of healthfulness'. Hospitals are not shrines to health: having comfort food on the premises does not negate their mission to help sick people.

I'm lucky in that the hospitals I've visited people in tend to be near interstate, thus, near fast food strips. All except one, where the nearest comfort food was a Hardee's (back in the dark ages, when they still sold roast beef sandwiches) that had the oddest smell. None of my relatives thought twice about hauling my child self off to Wendy's, though that was partly to get me out of the way while doctors were in with Mom. They even bought me *whispers* milkshakes.

I wish people would stop with the delusion that a Big Mac is going to cause everyone who sees it to catch the dreaded deathfat. Of course it would be nice if people realized that they're really going to die eventually, fat or thin, that fat people know they are fat, that weight does not meansure morality, etc. While I'm wishing, I'd like a pony, too.

Which makes me sad on a whole different level, mainly because Chick-Fil-A *as a corporation* supports all sorts of appalling theocratic policies which has kept me from eating there for years and years, even though Chick-Fil-A is one of my childhood comfort foods (A pickle on a fried chicken sandwich? Madness -- or GENIUS?)

I'm not terribly fond of McDonalds as a corporation either, but at least they don't allow concealed carry on the premises (unlike Starbucks).

But honestly, when someone I love is in the hospital, the only thing I want to think LESS about than possible nutritional deficiencies is politics.

ETA -- the hospital that served my undergraduate university had cafeteria facilities very much like Dav's -- and cheap, too (subsidized for poorly paid hospital workers, perhaps?) Anyway, as soon as I discovered this treasure (not well known among the student body) I cancelled my meal plan and bought all my breakfasts and lunches at the hospital.

I would say all the hospitals I have been to had good cafeterias, and the ones here in Boston had excellent ones. Not cheap, though. Barely affordable for visitors and outpatients, although there were some things for a few dollars, like packages of cereal and slices of pizza.

AFAIK hospital staff eat in the cafeteria, but it's often not open or very minimally open on night shift.

I find McDonalds' food very acceptable, and really I don't have objections to the corporation on that score. Generally cafeterias seem like a better option, with more options. I can see having satellite McDonalds or Starbucks (I think Children's Boston has an Au Bon Pain) to serve places far from the cafe, offer more variety, or different hours, whatever. Or maybe some hospitals aren't big enough to have a whole cafeteria?

I've spent more time than I care to think about at the big University Medical Center downtown, visiting my mom or my dad after various surgeries. The cafeteria makes a stab at healthy, but it has never sounded appetizing to me. BUT. We live in Wendy's country, and there's a full-bore Wendy's (not limited menu - everything - and open pretty decent hours) in the hospital. (There's also a boutique coffee/tea/chai/smoothy place and a Cheryl's Cookies.)

That Wendy's is a life-saver, in my opinion. It means you can spend the entire day in the hospital visiting someone, without having to deal with university traffic and intersections to get somewhere with edible food.

When I was in the hospital in 2000, trying not to die of Crohn's Disease (more specifically, my intestines having ruptured), the hospital food was inedible. Also trying to kill me, since much of it made me ill, which is not desirable when one is already in the ICU and trying not to die. I'd get past the broth and jello stage, try solid food from the cafeteria and puke. Back to broth and jello. My parents asked my surgeon if non-hospital food was okay for me to try, and he okayed it (within certain parameters, due to my healing intestines and the whole puking up everything solid we'd tried so far thing). The first food I was able to keep down was fast food. (My parents were in no condition to whip up home cooked meals, being busy practically living at the hospital.)

From my personal experience, I'd say putting in anything that is not whatever evil goop they make "food" out of in a hospital cafeteria is an improvement. And that may include Soylent Green.

I assume that your husband will sleep at home at night, and then drive in to visit you during the day? If so I'd suggest checking the route between home and hospital for nearby grocery stores, delis, sub shops, etc. That way he cold pick something up for lunch on his way to you, and eat when he wants. A grocery store with a good prepared food section can be as cheap as fast food, but much more nutritious.

You might also check if the hospital has a fridge and microwave that guests can use. Packing something from home or frozen or prepared meals from the grocery store might then be a good option.

Also, at least around here, many of the hospitals, particularly the ones in the city rather than the suburbs, have quite a few street vendors who set up outside the hospital every day. That might be another affordable option. In my area, they'll generally serve hot dogs, Polish sausage and Italian sausage, all from local butchers, as well as some sort of veggie burger option.

The folks at your ward's nursing station will likely know the local places for things like take-out Chinese or pizza, as well as if there are any local diners or other inexpensive options nearby. For example, when visiting a friend who was in the hospital a few months ago, she had a sudden desire for ice cream. And there was a convenience store within walking distance, just on the other side of the parking lot, where I could go to get her an ice cream bar. Near the hospital can be as convenient as in the hospital, and much more affordable.

If the hospital is affiliated with an university, there may be nearby cafeterias in the university, that could provide other options.

And, if you can afford it, there are worse ideas than him ordering a couple of sheet pizzas for the people working on your floor to share, where he can grab a slice or two himself, and they get a treat. Or a "thank you" cake, a few dozen doughnuts, etc. Letting the people who are caring for you know that you appreciate them is nice, since they often can be taken for granted or blamed for things they can't control.

The visitor's information desk may also have advice on local places to eat.

Generally, since hospitals are crowded places filled with employees and visitors, all of whom need to eat, they'll attract a lot of nearby businesses devoted to feeding the hungry hordes. But they may not be obvious to people unfamiliar with the area and distracted by concerns for their ill loved-one.

And it might also be worth locating a hotel near the hospital, so you know, in advance, a place your husband can stay overnight nearby if necessary. That falls under planning for an emergency to be sure it doesn't happen.

I love this. Thank you so much for this. I used to work in a nursing home/surgery rehab where we regularly had friends & families bringing in McD's, pizza, Dairy Queen, whatever was their loved one's favorite. Some people were against it because it's not healthy for them don'tya know and the whole healthcare system seems to revolve around the number on your scale. But it made them happy, and happiness is a *very* powerful healer. And for some of them it was the only real pleasure they had at that time in their lives.

As someone whose mother was in and out of the hospital for my entire childhood (and into my now-adulthood), I just want to second this. A Happy Meal would have been both comforting and given me something shiny and distracting, so I could have been less distressed about how Mom smelled funny and couldn't make complete sentences.

Which in turn would have made HER less distressed, because seeing your own kid in distress is HELLA DISTRESSING, especially when you know it's because of your condition but you can't do anything to fix it. (I think she would have told my grandparents to stop bringing me altogether, except she knew that even with the distress, both of us were happier seeing one another than not.)

As it was, my grandparents sometimes stopped at McDonald's for me on the way home. Neither of them liked the food, but they knew I did and it would make me feel better. But how much easier it would have been if I'd been able to stay visiting with my mom AND eat my dinner!

We have two hospitals in my hometown, and I'm well-acquainted with the food service at both, having worked in both and also been an inpatient in both (not at the same time). One has impressively good food: the vegetables are fresh, the meat isn't re-constituted or pressed patties of odds and ends, and the staff are well-trained on things like food allergies and intolerances, and will cook much of what's on the menu to-order.

The other is standard cafeteria fare, so much like the stuff at my public high school that I was amazed it didn't come on those itty-bitty Styrofoam trays. The staff had ZERO grasp of what food allergies or intolerances were. I have celiac disease and I had to police EVERYTHING their cafeteria sent to my room, because often things they swore were "gluten-free" actually weren't - like the prepackaged salad they sent that had croutons on it or the "rice cereal" they sent up that was obviously Rice Krispies (sweetened with barley malt and so not GF).

I actually think both facilities could have benefited from a McDonald's or other "known-quantity" national chain on the premises. The one at the first hospital would probably get used a lot less, since their in-house food was so well done and incredibly affordable (I used to get a yogurt with strawberries cut into it and an orange juice there for breakfast, when I worked as a records clerk there. Grand total: $2.10). But even folks from town didn't always know the cafeteria was so good, and some of them might just have preferred food they knew. The other hospital's McD might have put their crappy cafeteria out of business, but I can't feel sorry about that even from an "OMG HEALTH!" standpoint, because honestly, McDonald's serves some more-nutritious and definitely better-tasting fare than that cafeteria did.

OK, I can't believe I'm defending McDonald's but yes, as Ana mentions, you can build a healthy meal at McDonald's if you want to. Grilled chicken, salads, yogurt with fruit, and milk are all available. Kids meals have apple slices they will sell you separately if you ask. If a hospital is so concerned about "educating" people, then make a big poster outside the McD's listing these options as "heart healthy" choices. Done.There are several good reasons to advocate that a hospital give up a horrible global corporation for food service and instead give the spot to a local family-owned business, but as soon as they start with the "fat people are a drain on society" BS, forget them. Good luck with your surgery, and best to you and your husband!

I definitely have some of the same reactions, though my specific foods are different. I can tell when I'm stressed -- even if sometimes the stress is as superficial as not knowing what I want from a restaurant menu -- when I suddenly crave grilled cheese. It's the menu item I always ordered as a (shy) child when requested to order for myself in a restaurant. It's also the item I ordered every time my dad dropped me off back at college after going home for the weekend.

Even now, as someone with anxiety and a tendency toward restrictive eating, in a high stress situation familiar food trumps all. In the case of this particular hospital cafe, I might be sufficiently comfortable to explore given the promise of (Starbucks) coffee. But even so, if I did not have a familiar food option, I could see myself going without food for a full day or so while I acclimated to the possibilities.

I tend to think it's a pity when McDonald's is the best option for finding food in a stressful situation, but this is because I grew up spoiled by choice. (Also, I can't eat McDonald's. Lots of other fast food is no problem, but there's something in McDonald's food that turns my stomach in truly unpleasant ways; it's even in the ice cream and salads, and I have no idea how they managed that.) If McDonald's is there, fine. If something else is there, also good. Having a range of choices (because everyone's comfort foods are different!) strikes me as more important than who provides those comfort foods.

Then again, I'm used to the hospitals etc. near where I live -- there's very little for-sale food in the hospitals themselves, though both do have rather sad little cafeterias, because most of them are pretty much heart-of-downtown locations. Within six blocks of either major hospital there are at least a dozen restaurants, some of them chains and some of them not. So any food services they try to put into the hospitals tend to fail, with the exception of the coffee shop; patients order from the kitchens, which will also send up trays for visitors if it is requested in advance, though I'm not sure how much that costs. I've never considered whether this is difficult for patients and visitors, really, because if I'm in the hospital I'm usually more focused on dealing with the situation than considering whether it's fair that I have to, and if I'm not in the hospital, it seems perfectly reasonable that the hospital should be focused on other stuff and basically contract out the food stuff. If someone who didn't know the area asked, they'd probably be sent to the information desk, where they have maps of nearby attractions and conveniences, and transit information and such.

Interesting to think about, though. I suspect my experiences are skewed by living in Canada, where health care is structured very differently than in the states, and patient experiences seem to be judged differently.

If your husband is a fan of delivery, you could try checking out a site like grubhub or foodtogoexpress which have online databases of all the restaurants that deliver in the area, if you can find out the hospital's zip code. You can order online too. Then he would only have to be gone 5 minutes to meet the deliveryperson at the lobby instead of hours looking for a place. I know that isn't the point of this post, but I thought if there wasn't any food he wanted at the hospital it could help, and he can find a restaurant chain he is familiar with so he will know if he is gonna like the food or not. Of course, I absolutely agree that having a food court in the hospital with recognizable brand like McDonalds would be easier and much cheaper... But if you don't find any other options I thought you could use the input of a takeout fiend :).

Hi, Mel! I kind of want to print out a bingo card for your last post and then check off all the squares. Do you wanna count with me? Sure you do!

1. You ignored my note about this being a 202 post and telling people to familiarize themselves with FA before posting because you had 'splaining to do to a fat woman about why she's fat! I love being told about why my body works the way it does from a stranger with no insight into my situation and probably no formal training in the subject matter!

2. You made a sweeping "nobody thinks" statement which is undoubtedly logically untrue, but it's always fun to tell a fat woman how every member of society responds to her, when you seem to have zero experience being either!

3. You compared being fat to an addiction, which means that you are assuming a premise about every fat person on this board, including me! Thank you, Mel, for making assumptions about my lifestyle! It's fun when strangers do that to me because I'm fat!

4. You decided that 'splaining about FA wasn't enough and you SCOLDED MY HUSBAND FOR NOT 'PACKING A COOLER' FOR A FIVE DAY, FULLY OUT-OF-TOWN-THE-ENTIRE-TIME HOSPITAL STAY THAT IS GOING TO BE MENTALLY AND EMOTIONALLY GRUELING ENOUGH WITHOUT TRYING TO FIGURE OUT HOW MUCH SANDWICH MEAT TO PACK. LOL! Fuck you, Mel! So many times over, because you have managed to royally piss me off!

5. You called my opinion about McDonald's in hospitals "a stupid idea"! Which is a very good way to get the blog mistress in a good mood early in the morning before she's had her baby donuts! Haha! Especially while you're telling her she's addicted and in denial! Wheeeeee! Being Privileged means never having to be polite, I guess.

6. You repeatedly posted bullshit misinformation to which I already linked a valuable FA 101 FAQ! Because being Privileged means never having to educate yourself or listen to other people's experiences! Why should you? You've got important 'splaining to do!

Because you violated the comment policy so many times in a single post, and because I'm a big fat bitch who's in denial about her own body and I'm additionally anxious to get back to my baby donuts, and because you decided that scolding my husband for shit you know nothing about is a good idea on my blog, here's a big fat ban in accordance with the moderation policy.

See I ignored your FA policy because FA is complete utter bullshit and I don't accept it. Sorry! I scolded your husband because making a sandwich and chucking some fruit and snacks in a cooler bag (of course I'm making the assumption that your husband will be returning home from the hospital each day) isn't rocket science last I checked. I have no experience of being fat? Sure I do, I'm a former fattie. Being fat isn't always due to food addiction, true. But I've seen some of the photos from NAAFA conventions and I'm sorry no one gets so fat that they need a mobility scooter when they're taking care of themselves. I posted no misinformation that I'm aware of. Calories in v calories out may be an over simplification but it's not misinformation, in my experience I'd say it's supported by peer reviewed evidence. I can point you to some studies if you like!

I enjoyed your rebuke immensely, it gave me a great post breakfast chortle. Thanks! :)

I remember listening to a radio show where they discussed the problem that, in multiethic communities, a lot of what hospitals serve as "comfort food" really doesn't match the food people are used to eating for comfort. (I don't remember any resolution to the discussion - I imagine there are some logistical difficulties with stocking a diverse set of foods, and I think we tend to underrate food as a healing thing.) This certainly matches how I felt when I read your post title - my first though was "ew, when I'm sick the last thing I would want is McDonalds." Which just comes down to having a different set of meals given to me when I was sick as a child. I have nothing against McDonalds as food, it's just not comforting to sick-me.

I agree with this. Also I'd worry a lot about McDonalds replacing existing options - if they make food you like that's great (and I certainly agree that food-you-like should absolutely be available in hospitals), but they don't make food I like (but I can/will eat it if it is the only food available) and for a lot of people they straight-up don't make food they can *eat* (they cater very poorly to any sort of dietary restrictions whether medical or moral). But to know whether that was a rational worry I'd have to know what the actual plan was.

That assumes there are existing options. Everything you say about McDonalds was true of the hospital cafeteria of the hospital I spent several months in. Now, maybe there have been huge leaps forward in hospital cafeterias in the past 12 years, but...

Hrm. I think I'm on the side of "McDonalds would not be my first choice of establishments to put in a hospital, but I like the idea of having something known in a scary place." And the idea expressed in the article is a bit silly - my local Y has a Subway, but there's nobody parading about saying that it's such a horrible idea because all the working-out people will then gorge themselves on sub sandwiches. Perhaps because Subway has managed to manage its image as being healthier and McDonalds has not. I wonder if that particular hate group would be as virulent about removing a Subway from a hospital.

Knowing full well that hospital food is, at best, a crap shoot when it comes to quality and price, though, I can totally see having some familiar chain establishments either inside or very near to the grounds - it's a known quantity and quality for a known price, and both of those things are important, especially when it comes to hospital care, which makes everyone pray that the insurance covers everything. (If they have insurance. If not, then we pray that the charity care pays for everything. Like I was when my girlfriend had surgery to remove some growths in her uterus, because the insurance wasn't going to pay for everything, and I didn't magically have 40K to be able to pay with.)

Hopefully, the nursing or reception staff are quite knowledgeable about local establishments and can direct your husband to the tastiest local cuisine in the area.

I work in a hospital,and I do tends to eat more sweets and high calorie foods than my metabolism burns through when I'm anxious or depressed. It's hard for me to not gain weight in the hospital, and the biggest problem is not the presence of mediocre comfort food when I'm frustrated or stressed, but the absence of healthy alternatives that are remotely appetizing. I'm trying to change my coping mechanisms and to eat fewer sweets and more vegetables, and that was a heck of a lot easier when I was doing rotations at one of the private suburban hospitals that had a good salad bar with new soups every day and freshly made wraps that tasted good with complete health information for about the same price as the burgers. Now I'm at a university-based city hospital, and my options are basically bad burgers and mediocre pizza, overpriced coffee and pastries, or wilted lettuce and canned green beans cooked into an unrecognizable yellow mush for twice the price of the burgers. I've still successfully been eating healthily the last few months because I've been on a less time-intensive rotation and had the time to invest in preparing food at home 90% of the time, but in a few months I'm going to be working 14 hour days and that's not going to be an option consistently. Making high calorie low nutrient foods unavailable is patronizing and smacks of punishment, but it's also likely to be less effective than making appealing higher nutrient lower calorie foods more easily accessible.

This. I certainly followed that pattern when I was living in residence and didn't have a kitchen -- when I was in the big residence, I had a full salad bar and a separate fruit bar available, plus two sandwich stations (one did hot pressed sandwiches and the other did cold ones), as well as (usually) at least three hot main courses that weren't too bad for food. When I was in a smaller residence with a less-fully-stocked cafeteria all of those options were scaled down or condensed, and I would up eating pizza, chicken fingers, and hot dogs way too often. The junky foods were available either way, but I didn't choose them if the healthier options were fresh and easy, though I'd certainly take pizza over The Same Sandwich As Every Day For A Week, even if I otherwise liked that sandwich.

Beguine, you've probably already tried this, but my way of trying to make sure there's always something healthy at meals during crunch times has been to combine preparing-stuff-for-taking with preparing-stuff-for-the-meal-I'll-eat-in-three-seconds. Grapes can be frozen for hot days, when the frozen texture and hit of sugar are an unusual combination. And I buy a lot of applesauce. It's not a perfect solution, but it can get me through the time-crunched months better than I otherwise would.

Then again, I also do a lot of it's-a-treat-but-it's-better-than-x justifications. My usual example is: I want something sweet, so I'll eat blueberry pie instead of blueberry cheesecake. The pie isn't as healthy as the blueberries themselves would be, of course, but it's healthier (for my needs) than the cheesecake would be. And then I don't go off feeling guilty for eating it, so I'm less tempted to binge as I fight off my food-related guilt. (The cycle of consoling yourself for eating stuff you regret having eaten by eating more stuff you'll regret in the future is strong and evil for me.) This example drives some people nuts and has gotten me yelled at on the internet before, so I apoligise in advance if it's hopelessly misplaced here, but I think that when people are planning out what foods will be available, and how they'll be offered, and so on, it's the kind of trade off that needs to be made a great deal.

I find the diet talk and tips really, super triggery. Could we warn for them, please, *especially* on FA threads? Guiltless eating is hard enough without implicit reinforcement that eating is something to feel guilty about. Please.

I ignored your FA thing because I don't agree with the Fat Acceptance movement and it's tendency to disregard actual scientific fact regarding calories in v calories out. Granted it is over simplified, but the amount of rubbish that FA types cherry pick to suggest that being fat is healthy is hilariously wrong. I don't know a single health professional who would agree with it. Science does not consistently support statements like "Fat protects against diabetes, stroke" and the other crap on Kate Harding's website.

Looking at the women in the NAAFA's convention pages made me want to be physically ill. Sad, but true. I find morbid obesity unhealthy, unattractive and I'm not interested in helping people enable their unhealthy lifestyles. In my experience, for me being fat WAS sheer laziness. I would much rather eat a box of ice creams and feel miserable than get off my fat butt and do something constructive. Losing 50 lbs was a major achievement and yes I've kept it off for five years. Am I a freak? No, I have DISCIPLINE.

I wish more people would put down their baby donuts and exercise some discipline.

Forgive my late comment. I’ve been thinking about this for days and haven’t been able to figure this out myself.

I’d like to learn more about your pervasive use of mocking terms like “Teh Fats” and “DEATHFATS.” One interpretation – which I automatically rejected as soon as I thought of it – is that you were using the term to ridicule a group with which you identify. That couldn’t possibly be right.

Another interpretation is that you use the term to define how others describe this group. That you are confronting mockery directed at your group. But that confuses me. As a feminist, I wouldn’t ever refer to myself as a femi-nazi, first because I hesitate to perpetuate an offensive, stereotypical, and largely uneducated and imprecise term, and secondly, because no one has ever called me that before and I would thus be assigning myself this hurtful identity. Because I’ve never heard of anyone ridiculing overweight people by assigning them the label “Teh Fats,” your use of this term reads like a self-created sense of injustice – that you’ve made up a hurtful term for yourself and are reacting against it. But, again, this can’t possibly be a reasonable interpretation.

Please note that this thread is currently on "moderator approval needed" for new comments because of the influx of non-Fat Acceptance comments which it has received.

I'm allowing this comment to publish so that I can use it as a stepping off point for 101/202 differentiation.

If I mark a post as a 202 post, I am effectively saying that this is not a post for educating people who do not share this marginalized identify. Those people can listen and learn and comment provided they comment respectfully, but asking the marginalized people in the conversation to take time to educate the privileged people is very inappropriate.

I have verified that "DEATHFATS" can be easily defined through both Google and Duck Duck Go. Please research the terms that confuse you before you ask the marginalized people on the blog to educate you as to why they communicate the way they do within their marginalized subculture.

You're right - I should have included the caveat "across many of your posts in the last many months" when choosing the word "pervasive." You're also right in pointing out that on this particular post, your goal was not to educate but to discuss amongst select readers.

I chose to post here because your 101 posts are further back in the history of this blog, and I didn't know if you continued to read their comments. I'm not trying to be inflammatory, I'm genuinely trying to learn, so I chose a more recent post upon which to comment in the hope that you or someone would chime in. Your term "DEATHFATS" most recently appeared as an aside in your (lovely) post on Disney's The Little Mermaid, but out of deference to your other readers, I didn't want to hijack that comment thread with this question. Trigger warnings are very useful, but even when present, the mere posting of a comment in a troublesome direction can vastly change the direction of a comment thread and I didn't want to risk upsetting anyone. I thought this would be a safer place. My apologies for upsetting you. Was there a more appropriate post in which to ask this question?

That's a genuinely good question: In future, I would recommend asking for 101 education on one of the weekly Open Threads, with appropriate warnings on the comment. (Like "TW: Asking for education on FA terminology" or something.) Then people who want to leap in and do the education thing can, and people who don't can carry on. If it becomes distracting to mix chatty open thread and educational open threads in the future, I can always post both every week.

Since we're already on the topic, DEATHFATS is a rephrasing of the term "morbidly obese", which is a clinical term used by the highly problematic BMI scale, and which has historically been wielded as a verbal weapon against fat people under the guise of supposedly caring about the person's health and using medical terminology as a shield against appropriate objections. "Morbid" comes from the Latin for "death", and "obese" is just another way of saying "fat", but (again) with clinical implications that there's something wrong/diseased about being so. So the word is a rephrase.

It would appear from your comment that you are not aware of word reclamation efforts in general*, so here is a good Wikipedia article to start with. (* I assume this because there are definitely feminists who work to reclaim misogynistic language like the example you provided earlier, so while you are welcome to not participate in word reclamation, it would be wrong to assume that no feminists do.)

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